The effect of eight weeks of combined exercise on interleukin-6, C-reactive protein, and lipid profile in patients with coronary artery disease.
Subject Areas : Exercise Physiology and Performance
Seyed Mazaiar Seyed Alikhani
1
,
Abdolali Banaeifar
2
*
,
Shahram Sohaily
3
,
Sajad Arshadi
4
,
Vahid Imanipour
5
1 - 1. Department of exercise physiology, ST.C, Islamic azad university, Tehran, Iran.
2 - Department of exercise physiology, ST.C, Islamic azad university, Tehran, Iran
3 - Department of exercise physiology, SHIAU, Islamic azad university, Tehran, Iran
4 - Assistant Professor of Exercise Physiology , South Tehran Branch , Islamic Azad university, Tehran, Iran.
5 - Department of exercise physiology, PA.c, Islamic azad university, Tehran, Iran
Keywords: combine training, interleukin-6, C-reactive protein, lipid profile, cardiovascular disease,
Abstract :
Background: Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, claiming approximately 17.9 million lives annually. Given the role of physical activity in the prevention and management of cardiovascular diseases, investigating the impact of exercise on inflammatory markers is of particular importance. Therefore, this study was conducted to evaluate the effect of eight weeks of combined exercise on interleukin-6, C-reactive protein, and lipid profile in individuals with coronary artery disease.
Method:In a randomized clinical trial, 24 patients with coronary artery disease, overweight or obesity, and an average age of 59 ± 8 years with a body mass index of 27.76 ± 0.42 were randomly assigned to two groups: combined exercise training and control. The training group followed a specific exercise protocol for eight weeks, with three sessions per week. Venous blood samples were collected before and after the intervention. For data analysis, the Shapiro-Wilk test was used to assess normality, while analysis of covariance and Bonferroni post hoc test were applied to compare mean values between groups. The final analysis was conducted using SPSS version 22.
Results: The results showed that combine exercises led to a significant decrease in the levels of inflammatory response protein (CRP) (p=0.025) and IL-6 (p=0.011) compared to the control group. Also, despite the decrease in the mean TG, TC, LDL indices and the increase in HDL, the changes were not significant (P>.05).
Conclusion: The results show that 8 weeks of combine training can reduce inflammatory markers and reduce the risk of cardiovascular disease.
1. Laranjo, L., Lanas, F., Sun, M.C., Chen, D.A., Hynes, L., Imran, T.F., Kazi, D.S., Kengne, A.P., Komiyama, M., Kuwabara, M. and Lim, J., 2024. World Heart Federation roadmap for secondary prevention of cardiovascular disease: 2023 update. Global heart, 19(1), p.8.
2. Zhao, D., 2021. Epidemiological features of cardiovascular disease in Asia. JACC: Asia, 1(1), pp.1-13.
3. Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease: The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC). European heart journal. 2021 Jan 1;42(1):17-96.
4. Libby, P., Buring, J.E., Badimon, L., Hansson, G.K., Deanfield, J., Bittencourt, M.S., Tokgözoğlu, L. and Lewis, E.F., 2019. Atherosclerosis Nat Rev Dis Primers 5 (1): 56 [online]
5. Mensah GA, Roth GA, Fuster V. The global burden of cardiovascular diseases and risk factors: 2020 and beyond. Journal of the American College of Cardiology. 2019 Nov 19;74(20):2529-32.
6. Jiang YJ, Sun SJ, Cao WX, Lan XT, Ni M, Fu H, Li DJ, Wang P, Shen FM. Excessive ROS production and enhanced autophagy contribute to myocardial injury induced by branched-chain amino acids: roles for the AMPK-ULK1 signaling pathway and α7nAChR. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2021 Jan 1;1867(1):165980.
7. Qazi, S.U., Hamid, A., Ansari, H.U.H., Khouri, M.G., Anker, M.S., Hall, M.E., Anker, S.D., Butler, J. and Khan, M.S., 2024. Trends in cancer and heart failure related mortality in adult US population: A CDC WONDER database analysis from 1999 to 2020. American Heart Journal, 278, pp.170-180
8. Lavie CJ, Arena R, Swift DL, Johannsen NM, Sui X, Lee D-c, et al. Exercise and the cardiovascular system: clinical science and cardiovascular outcomes. Circulation research. 2015;117(2):207-19.
9. Pakdaman M, Gravandi S, Askari R, Shafii M, Khaleghi Muri M, Bahariniya S. Estimation of the economic burden of cardiovascular diseases in selected hospitals of Yazd in 2018. Qom University of Medical Sciences Journal. 2020;14(7):58-68.
10. Saadat S, Yousefifard M, Asady H, Jafari AM, Fayaz M, Hosseini M. The most important causes of death in Iranian population; a retrospective cohort study. Emergency. 2015;3(1):16.
11. Tian D, Meng J. Exercise for prevention and relief of cardiovascular disease: prognoses, mechanisms, and approaches. Oxidative medicine and cellular longevity. 2019;2019(1):3756750.
12. Nystoriak MA, Bhatnagar A. Cardiovascular effects and benefits of exercise. Frontiers in cardiovascular medicine. 2018;5:408204.
13. Ohsuzu F. The roles of cytokines, inflammation and immunity in vascular diseases. Journal of atherosclerosis and thrombosis. 2004;11(6):313-21.
14. Libby P, Theroux P. Pathophysiology of coronary artery disease. Circulation. 2005;111(25):3481-8.
15. Madjid M, Willerson JT. Inflammatory markers in coronary heart disease. British medical bulletin. 2011;100(1).
16. Tabaei S, Motallebnezhad M, Tabaee SS. Systematic review and meta-analysis of association of polymorphisms in inflammatory cytokine genes with coronary artery disease. Inflammation Research. 2020;69:1001-13.
17. Christodoulidis G, Vittorio TJ, Fudim M, Lerakis S, Kosmas CE. Inflammation in coronary artery disease. Cardiology in review. 2014;22(6):279-88.
18. Plebani M. Why C-reactive protein is one of the most requested tests in clinical laboratories? Clinical Chemistry and Laboratory Medicine (CCLM). 2023;61(9):1540-5.
19. Beckman JA, Preis O, Ridker PM, Gerhard-Herman M. Comparison of usefulness of inflammatory markers in patients with versus without peripheral arterial disease in predicting adverse cardiovascular outcomes (myocardial infarction, stroke, and death). The American journal of cardiology. 2005;96(10):1374-8.
20. Mirmiran P, Esfandiar Z, Hosseini-Esfahani F, Koochakpoor G, Daneshpour MS, Sedaghati-Khayat B, et al. Genetic variations of cholesteryl ester transfer protein and diet interactions in relation to lipid profiles and coronary heart disease: a systematic review. Nutrition & metabolism. 2017;14:1-15.
21. Paknahad Z, Zeraei-Bidgoli H. Metabolic syndrome and nonalcoholic fatty liver disease: Nutritional approach for prevention. Journal of Isfahan Medical School. 2013;31(252):1461-80.
22. Nazari B, Asgary S, Sarrafzadegan N, Saberi S, Azadbakht L, Esmaillzadeh A. Evaluation of types and amounts of fatty acid content in some most consumed Iranian fast foods. Journal of Isfahan Medical School. 2009;27(99):527-35.
23. Schumann M, Rønnestad BR. A brief historical overview on the science of combine aerobic and strength training. Combine aerobic and strength training: scientific basics and practical applications. 2019:1-6.
24. Acosta-Manzano P, Flor-Alemany M, Van Poppel MN, Coll-Risco I, Segura-Jiménez V, Stanford KI, et al. Combine exercise training during pregnancy is related to more favourable maternal lipid levels when IL-8 increases. Journal of Sports Sciences. 2025:1-15.
25. Lentejas JPR, Sandoval MAS, Evangelista TJP, Buenaluz-Sedurante MD, Velayo CL. The Effect of Resistance, Aerobic, and Combine Aerobic and Resistance Exercises on Inflammatory Markers of Metabolically Healthy Overweight or Obese Adults: A Systematic Review and Meta-analysis. Acta Medica Philippina. 2024;58(21):90.
26. da Silva LA, de Almeida Pereira DA, Ribeiro SAV, de Oliveira Sediyama CMN, Priore SE. Effect of combined physical exercise on inflammatory markers and the relationship with body composition in young women. Journal of Bodywork and Movement Therapies. 2024;39:73-8.
27. Volterrani M, Caminiti G, Perrone MA, Cerrito A, Franchini A, Manzi V, et al. Effects of combine , within-session, aerobic and resistance exercise training on functional capacity and muscle performance in elderly male patients with chronic heart failure. Journal of clinical medicine. 2023;12(3):750.
28. Malandish A, Gulati M. The impacts of exercise interventions on inflammaging markers in overweight/obesity patients with heart failure: A systematic review and meta-analysis of randomized controlled trials. IJC Heart & Vasculature. 2023;47:101234.
29. Bagheri R, Kargarfard M, Jalali K, Ashtary-Larky D, Cheraghloo N, Ghobadi H, et al. The effects of 12 weeks of combine and combined training on inflammatory markers, muscular performance, and body composition in middle-aged overweight and obese males. Nutrients. 2023;15(6):1482.
30. Amiri R, Sadeghi H, Borhani Kakhki Z. The Effect of Cardio, Aerobic and Combine Rehabilitation on Hemodynamic and Biomechanical Indicators in Older Men With Coronary Artery Disease. The Scientific Journal of Rehabilitation Medicine. 2023;12(3):432-45.
31. Sobhani V, Shakibaei R, Gholami M, Arabzadeh E. Effect of eight weeks of combined exercise and omega-3 supplementation on the levels of inflammatory and anti-inflammatory cytokines in elderly women. Comparative Exercise Physiology. 2024;20(3):273-82.
32. Makiel K, Suder A, Targosz A, Maciejczyk M, Haim A. Effect of exercise interventions on irisin and interleukin-6 concentrations and indicators of carbohydrate metabolism in males with metabolic syndrome. Journal of Clinical Medicine. 2023;12(1):369.
33. Orange ST, Leslie J, Ross M, Mann DA, Wackerhage H. The exercise IL-6 enigma in cancer. Trends in Endocrinology & Metabolism. 2023;34(11):749-63.
34. Silva FM, Duarte-Mendes P, Teixeira AM, Soares CM, Ferreira JP. The effects of combined exercise training on glucose metabolism and inflammatory markers in sedentary adults: a systematic review and meta-analysis. Scientific Reports. 2024;14(1):1936.
35. Kanthajan T, Pandey M, AlQassab O, Sreenivasan C, Parikh A, Francis AJ, et al. The Impact of Exercise on C-reactive Protein Levels in Hypertensive Patients: A Systematic Review. Cureus. 2024;16(9).
36. Pedersen BK, Fischer CP. Physiological roles of muscle-derived interleukin-6 in response to exercise. Current Opinion in Clinical Nutrition & Metabolic Care. 2007;10(3):265-71.
37. Aguirre LE, Villareal DT, editors. Physical exercise as therapy for frailty. Nestle Nutrition Institute Workshop Series; 2015.
38. Shabani R, Jalali Z, Nazari M. Effects of combine strength and aerobic training on blood glucose homeostasis and lipid profile in females with overweight and obesity. Zahedan Journal of Research in Medical Sciences. 2018;20(4).
39. Pérez-López A, Gonzalo-Encabo P, Pérez-Köhler B, García-Honduvilla N, Valadés D. Circulating myokines IL-6, IL-15 and FGF21 response to training is altered by exercise type but not by menopause in women with obesity. European Journal of Sport Science. 2022;22(9):1426-35.
40. Hasanah U, Rejeki PS, Wungu CDK, Pranoto A, Izzatunnisa N, Rahmanto I, et al. High-intensity combination exercise has the highest effect on increasing serum irisin and interleukin 6 levels in women with obesity. Journal of Basic and Clinical Physiology and Pharmacology. 2024;35(1-2):71-8.
41. Silva FM, Duarte-Mendes P, Carvalho E, Soares CM, Farinha C, Serrano J, et al. Effects of combined training during the COVID-19 pandemic on metabolic health and quality of life in sedentary workers: A randomized controlled study. Frontiers in Public Health. 2022; 10:1040714.
42. Amaro-Gahete FJ, Ponce-González JG, Corral-Pérez J, Velázquez-Díaz D, Lavie CJ, Jiménez-Pavón D. Effect of a 12-week combine training intervention on cardiometabolic health in obese men: a pilot study. Frontiers in Physiology. 2021; 12:630831.